Objective To assess the impact of transurethral resection of bladder tumor (TURBT) and radical cystectomy (RC) on the survival outcomes of patients with T2aN0M0 stage muscle-invasive bladder transitional cell carcinoma (BTCC). Methods The clinical and prognostic data of patients diagnosed with T2aN0M0 muscle-invasive BTCC from 2010 to 2015 were extracted from the SEER database using SEER*Stat software. A 1∶1 propensity score matching (PSM) method was employed to balance the baseline data discrepancies between the TURBT and RC groups. Kaplan-Meier methods was used to plot survival curves,and overall survival (OS) and cancer-specific survival (CSS) were compared using the log-rank test. Univariate and multivariate Cox regression were conducted to identify the independent risk factors of CSS. Results A total of 1032 patients diagnosed with T2aN0M0 BTCC were included in this study. There were 270 patient records in both the TURBT group and the RC group,following 1∶1 PSM. The log-rank test indicated that there was a significant difference in both OS and CSS between the RC and TURBT groups (P<0.001),with the RC group demonstrating a superior prognosis. The results of the multivariate Cox regression analysis revealed that TURBT,age over 60 years,unmarried status and tumor diameter exceeding 5.0 cm were independent risk factor for CSS in patients with T2aN0M0 muscle-invasive BTCC,in contrast,RC was identified as a protective factor of prognosis (HR=0.387,95％CI:0.282～0.532,P<0.001). Conclusion RC is associated with improved CSS in patients with T2aN0M0 muscle-invasive BTCC,which is a more effective treatment option.
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